Provider Demographics
NPI:1285628883
Name:BITTINGER, JILL KIMBERLY (MSN FNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:KIMBERLY
Last Name:BITTINGER
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:KIMBERLY
Other - Last Name:SALATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:340 TAMIAMI TR. N #168
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102
Mailing Address - Country:US
Mailing Address - Phone:239-450-9308
Mailing Address - Fax:
Practice Address - Street 1:3363 TAMIAMI TR, N SKIN DEEP NAPLES
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-260-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9341297363LF0000X
FLAPRN9341297363L00000X
MDR130805363LF0000X
MNR 168491-7363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily